{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T18:35:42Z","timestamp":1775759742266,"version":"3.50.1"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background.<\/jats:title>\n                  <jats:p>Molecular diagnostics enable sensitive detection of respiratory viruses, but their clinical significance remains unclear in pediatric lower respiratory tract infection (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods.<\/jats:title>\n                  <jats:p>Molecular testing was performed for respiratory viruses in nasopharyngeal aspirates collected from children aged &amp;lt;5 years within 24 hours of hospital admission during sentinel surveillance for severe acute respiratory illness (SARI) hospitalization conducted in South Africa during February 2009\u2013December 2013. The primary outcome was life-threatening disease, defined as mechanical ventilation, intensive care unit admission, or death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results.<\/jats:title>\n                  <jats:p>Of 2322 HIV-uninfected children with respiratory syncytial virus (RSV)\u2013associated LRTI, 1330 (57.3%) had RSV monoinfection, 38 (1.6%) had life-threatening disease, 575 (24.8%) had rhinovirus, 347 (14.9%) had adenovirus (ADV), and 30 (1.3%) had influenza virus. RSV and any other viral coinfection was not associated with severe disease (odds ratio [OR], 1.4; 95% confidence interval [CI], OR, 0.74; 95% CI, .39\u20131.4), ADV coinfection had increased odds of life-threatening disease (adjusted OR, 3.4; 95% CI, 1.6\u20137.2; P = .001), and influenza coinfection had increased odds of life-threatening disease and prolonged length of stay (adjusted OR, 2.1; 95% CI, 1.0\u20134.5; P = .05) compared with RSV monoinfection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions.<\/jats:title>\n                  <jats:p>RSV coinfection with any respiratory virus is not associated with more severe disease when compared to RSV alone in this study. However, increased life-threatening disease in RSV-ADV and RSV-influenza coinfection warrants further study.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciw756","type":"journal-article","created":{"date-parts":[[2016,11,20]],"date-time":"2016-11-20T12:05:57Z","timestamp":1479643557000},"page":"443-450","source":"Crossref","is-referenced-by-count":33,"title":["Severity of Respiratory Syncytial Virus Lower Respiratory Tract Infection With Viral Coinfection in HIV-Uninfected Children"],"prefix":"10.1093","volume":"64","author":[{"given":"Natalie I.","family":"Mazur","sequence":"first","affiliation":[{"name":"Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand 1 , Johannesburg ,","place":["South Africa"]},{"name":"Wilhelmina Children\u2019s Hospital 2"},{"name":"Julius Global Health Center for Health Sciences and Primary Care, University Medical Center Utrecht 3 ,","place":["The 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